| NPI | 1639339336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: GA 066615) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NY 2378151) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: SC 31339) | |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2022-06-20 |